Endovascular abdominal aortic aneurysm repair in patients with ventricular assist devices

Long-term mechanical circulatory support devices are currently an established therapy for the management of end-stage heart failure, and current evidence supports their superiority in comparison to maximal medical therapy in these patients. Screening for peripheral arterial disease and abdominal aortic aneurysm (AAA) before left ventricular assist device (LVAD) implantation is recommended. Although repair of AAA before or during LVAD placement has been reported, management of patients with AAA after LVAD implantation needs to be further investigated. We describe our management and operative strategies in 2 patients on destination LVAD therapy who underwent successful endovascular AAA repair.